Chest drainage tubes for the drainage of air trapped in a patient's thorax or pleural space (hereafter referred to collectively as a “chest cavity”) are often used to allow for drainage of air trapped therein following trauma. Typically, such chest tubes have one or more holes at a distal end, and a lumen in fluid communication therewith via which the air is evacuated from the patient's body. The chest tubes typically include features, e.g., shutoff valves and/or duckbill valves, to prevent backflow of air into the chest cavity.
Chest tubes are typically inserted into a patient's chest cavity with a trocar mounted to the internal lumen. The trocar is stiff, substantially pointed at the distal end, and allows for advancement of the flexible chest drainage tube into an incision in the chest wall. Such a trocar is useful for initial insertion of the chest tube, but becomes a dangerous instrument once the chest tube is advanced below the level of the ribs.
One consideration when inserting a drainage tube into a patient's chest cavity is maintaining sterility of the site. Inserting of the chest tube, especially in an emergency setting, requires a sterile scrubbing of the incision area and incision into the chest wall with sterile instruments. These incisions are, understandably, difficult to perform aseptically in the field, where the insertion site may be bloody, dirty, or otherwise contaminated. In addition, maintenance of sterility in the area of chest tube penetration into the chest has been difficult as has been the ability to hold the chest tube in position once it has been introduced into the patient. The use of surgical gloves to maintain sterility becomes problematic since the gloves become contaminated quickly in the typical field environment.
US 2005/0234390 discloses a device which utilizes a chest tube with a cutting distal end and a central blunt trocar. The blunt trocar or obturator shields the sharp cutting distal end of the chest tube until controllably retracted. Once the blunt trocar or obturator is retracted, the chest tube is advanced out through its sterile, protective package and into the patient. The blunt trocar is advanced back into its position to shield the sharp tip of the chest tube during patient insertion. The chest tube also includes a hold-down mechanism that is created by an adhesive seal to the patient's chest and ribbons or straps that are wrapped around the chest tube once it is correctly positioned. The straps include adhesive ends to grip the chest tube once the straps are in place.